Pilot Flight Training Registration Form

Select desired Table Top Date:
Select training Location and Date:
Pilot information - - - - - - - - - - -
*Name:	*Phone
Street:
Town:	State Zip
*E-Mail:

Aircraft model:	Year:	N#:
List any special equipment or modifications:
Insurance: You must have insurance to participate in the flight training portion. Contact you insurance agent and have them issue a certificate of insurance, a copy of which must be presented prior to any flight training at the clinic.
Pilot History - - - - - - - - - - -
Total time: Time in type: IFR ?: yes no
Select Payment- - - - - - - - - - -
$850 - Full course (ground + flight) $800 - Full course (early payment) $425 - Ground only (no flight) $400 - Ground (early payment)
Discount policy: Full payment received two (2) weeks prior to the clinic will be eligible for the early payment rate above. Cancellation policy: If you cancel more than two (2) weeks prior to the scheduled date you will receive a full refund. If you cancel within two (2) weeks prior you will receive a 50% refund, or you may reschedule for another clinic within one years time for no additional cost. Please print this completed form before clicking "send", or return to it using your browser's back arrow.
Make checks out to Comanche Pilot Training (company checks should include you name on the memo line)	Mail form and payment to: Pilot Training c/o Peter Morse 104 Woodside St Putnam CT 06260
*required fields
Upon clicking "Send" above you will see a Thank you page listing all the information you have supplied. Use your back arrow to return and print this form to complete your registration. We will send a reply to the email address you provided in a timely manner. Thank you for your interest in NE Comanche Training.